Individual Management of Drug extravasation~4

DRUG

GROUP

ASPIRATE

And instill

steroids001

'SPREAD’ AND DILUTE

 

LOCALISE AND NEUTRALISE

SPECIFIC MANAGEMENT

ADDITIONAL

INFORMATION

Methotrexate

2

Y

 

Y

Apply topical hydrocortisone and cover the area with an ice pack h for the next 4 hours. If the local reaction has then settled apply heat g for a further 24 to 48 hours. 2

Possibility of local inflammation. S/C hyaluronidase may facilitate dispersion of large volume extravasations in addition to the warm compressions

Mitomycin

5

Y

 

Y

Apply topical DMSO, every 2 hours at the extravasation site followed by topical hydrocortisone cream and a cold compress. 1 h

Avoid contact with good skin. If blistering occurs, stop the DMSO and seek further advice. Surgical excision e is sometimes required to prevent serious damage

Mitozantrone

4

Y

 

Y

Apply topical DMSO, every 2 hours at the extravasation site followed by topical hydrocortisone cream and a cold compress. 1 h

Possibility of local inflammation or necrosis and/or pain

Mustine

5

Y

 

Y

Infiltrate the area with sodium thiosulphate.b Introduce a further 100 mg of hydrocortisone to the infiltrated area. Apply cold compression for 12 hours.h

Surgical excision e is sometimes required to prevent serious damage

Oxaliplatin

4

Y

Y

 

Infiltrate with hyaluronidase a and a 500 ml bag of 5% dextrose plus further hyaluronidase a should be placed in the centre of the extravasation area in a ‘hypodermoclysis’ f fashion, the area warmed to aid dispersion. The fluid should be left up to 8 hours or until the 500ml is dissipated.

Caution in diabetic patients

 

 

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